In recognition of Alcohol Awareness Week, we spoke to some of our accredited services whose Alcohol care teams were highlighted as exceptional by our assessors. They told us how they run services for alcohol related disease so well and spoke about the challenges they face.

Royal Cornwall Hospital

Royal Cornwall Hospitals NHS trust

Gained IQILS accreditation in 2022 

Alcohol services in Cornwall deal with a dispersed rural population of 568,210, with currently 29% of those with alcohol use disorder engaged with local structured alcohol treatment.

The alcohol care team in Cornwall integrates the hospital-based alcohol liaison team (ALT), hepatology services and the community alcohol services. There are tri-directional referral pathways between these services with patient self-referral and primary care referrals.

The hospital ALT provides a seven-day service for the hospital, for the detection and prompt treatment of alcohol use disorder, an alcohol related brain injury pathway, education for the use of AUDIT screening, fibro scan for those with alcohol related liver disease and telephone follow up of patients. One of the key reasons for success is that the service is well regarded by the emergency department, discharge lounges and wards, since over 95% of referred patients are seen within 24 hrs. The team participates in the emergency department morning huddles to identify potential patients and reduce admission of those with uncomplicated alcohol related disease. Moreover, the ALT inputs into research projects and teaching, with close links with the community alcohol team. The team has excellent service user and hospital staff feedback.

The service has also benefited from the employment of a virtual hepatology clinical nurse specialist. With extensive mental health experience, our CNS provides two clinics per week offering psychological support, with inputs from clinical hepatology, general practice, the hospital ALT and community alcohol services.

Community alcohol services provide the backbone of treatment for alcohol use disorder patients, with tailored one to one support and remote access if required, clinical support and medication to prevent relapse, detoxification and rehabilitation, group meetings and social support.

The service has been successful by providing a fast track into alcohol treatment or hepatology services, embedded multidisciplinary meetings, end of life care and education of alcohol frontline workers, aided by an electronic dashboard to track the progress of patients and record previous interventions. The integration of hospital and community-based services to create a streamlined regional service, with ease of access to both patients and clinical staff, has been a key factor in the success of the service.

One of the challenges which make caring for alcohol related issues uncertain, is future staff recruitment for succession planning with the current financial constraints affecting the health service in Cornwall. The major future aim of the service is to increase the number of dependant drinkers engaged with structured alcohol treatment to minimise relapse, hospital admission and alcohol related disease progression.

Thank you to the Cornwall hepatology team for their contribution and continued excellence.